A novel simulation to prepare maternal caregivers of children diagnosed with a critical congenital heart defect

Purpose

The purpose of this feasibility study was to determine the effectiveness of an interprofessional led low-fidelity simulation program over three timepoints on maternal caregivers' perceived stress, sense of competence and discharge readiness for care of critical congenital heart disease (CCHD) infants requiring neonatal cardiac surgery.

Design and methods

The Perceived Stress Scale (PSS) was administered to simulation and non-intervention groups at three timepoints: prenatal period, Cardiac Acute Care Unit (CACU) transfer, and rooming-in. Parental Sense of Competence (PSOC) was measured at timepoint two and three, and Readiness for Hospital Discharge (RDHS) was measured at timepoint three for the simulation group. A linear mixed model was used to examine PSS and PSOC scores over time.

Results

Of the thirty-three maternal caregivers, twelve were in the simulation group and twenty-one were in the non-intervention group. In the simulation group, the odds of having moderate-high stress were significantly lower at rooming-in compared to the prenatal period. From timepoint two to rooming-in, there was a positive change in PSOC scores. RDHS scores represented good readiness for discharge.

Conclusion

Findings suggest that simulation may improve maternal caregiver stress from prenatal CCHD diagnosis to discharge home after cardiac surgery. Future work should include random treatment assignment to assess causal relationships.

Practice implications

Infants with CCHD require extensive postoperative recovery and specialized home care. Maternal caregivers of critically ill CCHD neonates are at increased risk for stress. Results from this study suggest engagement with nurses and interdisciplinary team during the prenatal period may reduce caregiver stress.